Provider Demographics
NPI:1437138542
Name:KNAPP, MICHELE MORANT (DO)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:MORANT
Last Name:KNAPP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04254-1529
Mailing Address - Country:US
Mailing Address - Phone:207-897-6200
Mailing Address - Fax:207-897-6300
Practice Address - Street 1:96 MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1511
Practice Address - Country:US
Practice Address - Phone:207-897-6200
Practice Address - Fax:207-897-6300
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME285430099Medicaid
E85845Medicare UPIN